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Organization
NORTHEAST GEORGIA PHYSICIANS GROUP, INC.
Active
Organization
NORTHEAST GEORGIA PHYSICIANS GROUP, INC.
Active
Parent organization
NORTHEAST GEORGIA HEALTH SYSTEM, INC.
Other names
MEDICAL TRANSPORT
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHEAST GEORGIA HEALTH SYSTEM, INC.
Authorized official
MR. ANTHONY M. HERDENER (VICE-PRESIDENT & CFO)
(770) 219-9000
Entity
Organization
Contact information
Practice address
665 LANIER PARK DR, GAINESVILLE, GA 30501-2059
(770) 219-0303
(770) 219-0561
Mailing address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 219-9000
(770) 219-0561
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
154-03
GA
343900000X
Non-emergency Medical Transport (VAN)
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00793625B
—
GA
Enumeration date
06/15/2006
Last updated
06/20/2018
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